Exchange transfusion in hemolytic anemia complicating disseminated lypus erythematosus; report of case of acquired hemolytic disease associated with rare blood group antibodies following whole blood transfusion

THE PRESENT case was deemed worthy of report for three reasons: (1) the occurrence of acquired hemolytic anemia subsequent to transfusion incompatibility in a patient with acute disseminated lupus erythematosus; (2) the occurrence and demonstration of blood group antibodies, anti-C, anti-A 1 , and a third incompletely identified atypical hemagglutinin, subsequent to multiple whole blood transfusions; (3) the use of exchange transfusion as a therapeutic agent during the most acute phase of intravascular hemolysis. REPORT OF CASE The patient, a 15-year-old white girl, was admitted to the hospital for the first time on July 9, 1949, with complaints of generalized weakness and fatigability and of migratory joint swellings. Her first difficulties began seven months prior to admission with a brief episode of low-grade fever and widespread joint pains which subsided until six weeks before admission, when fever and alternate warm painful swellings of the finger, elbow, and knee points again developed.